1.3.22 Employee surveys

Goal and purpose

If there is uncertainty about the assessment of the hospital or if changes in the attitude of employees towards the hospital are feared, employee surveys can help to uncover previously unknown issues. However, it should be noted that the informative value often falls well short of expectations. The pitfalls and statistical limitations of surveys should be taken into account. The costs of such surveys are considerable and should be set in relation to the knowledge gained.

Employees' requirements regarding working conditions and health and safety problems should be surveyed regularly.

The results should be communicated appropriately.

Problem definition

Informing the management about the expectations, needs, opinions and feelings of the employees in the hospital. Employees' comments to the management on general problems and perceptions in the hospital. Identification of deficits in the management of the hospital that can lead to disruptions in employee motivation and commitment. Method of testing whether QM measures have had the desired effect.

Employee surveys can be conducted in relation to occupational groups, departments or all employees of the hospital or a group of hospitals. Employee surveys cannot replace open dialogue and careful observation of the mood in the hospital. Employee surveys can be designed as heuristic studies (i.e. to detect individual, possibly random findings) or as systematic studies whose findings are based on a statistical analysis.

The heuristic findings must be carefully weighed up. It must always be realised that they do not necessarily have to be representative. In the case of systematic studies, the methodological rules of an empirical study must be observed, as otherwise the statements are worthless. If the survey is intended to measure the effectiveness of QM measures in a before/after comparison, the confidence interval of the statements must remain assessable through the statistical analysis.

Result

Valid statements on the issues that gave rise to the employee survey.

Solution

Survey objective

The first step is to determine the objective of the employee survey. Should the employees' attitude towards their work and working conditions (job satisfaction) be analysed? Should the management levels be assessed by the employees? Should employee loyalty to the hospital be determined? Do you want to investigate the general state of mind (working atmosphere)? Should the level of information provided to employees on certain points be determined (effectiveness of information strategies)?

Questionnaire

The questions should be formulated in such a way that they directly enquire about the characteristic to be analysed. For more complex characteristics, such as satisfaction, this is not possible. In this case, several questions must be asked in such a way that the more general characteristic is largely covered. Examples of questions:

• Individual characteristic "Duration of collaboration": How long have you worked at our hospital?
• Complex characteristic "Attachment to the hospital (affective commitment)", assessed from:
• Do you enjoy going to work?
• Do you enjoy your work?
• Are you happy when you get off work?
• Do you sometimes feel unfairly treated?
• Have you ever thought about changing jobs, moving to another city or another industry, etc.?

The questions should be formulated in such a way that they can be answered by the interviewee. Questions such as "Do you consider the management to be ...", which are answered with a guess or the supposed opinion of others, are pointless as the respondent's own experience is usually lacking. The internal coherence of the questionnaire must be carefully tested. We therefore strongly advise against creating your own questionnaire. The client should always select a competent researcher (references?) and utilise their experience when creating the questionnaire. This applies in particular to questions about general characteristics such as job satisfaction, the degree of communication between professional groups, commitment to quality improvements or the willingness to identify problems and propose solutions. The possible answers to the questions should be carefully considered. There are several options to choose from, all of which have their advantages and disadvantages:

• Dichotomous questions: "Yes/No" or "Agree - Disagree"
• Questions to be answered using a scale:
• with 3 points (good - average - poor), with 5 points (very good - good - satisfactory - poor - very poor)
• Scales without a mean value with 4 or 6 points to suppress a tendency towards the centre. The necessity of this must be weighed up in each individual case.
• Open, non-scaled evaluation: "Place a line somewhere between the point "Very good" on the left and the point "Very bad" on the right end of the scale!"
• Symbols J K L are often used instead of words or numbers.

Questions on social background should be limited to characteristics that make sense for the statement. Asking about age, gender, length of service and function usually allows the respondent to be identified and severely restricts their impartiality. There should always be options such as "Can't or don't want to answer/assess", "Other answer" and sufficient space for free text to allow for comments or remarks. The graphic design of the questionnaire should invite completion and, if economically justifiable, be printed.

Scope of the survey

It must be clarified whether the survey is to be conducted as a total survey or a random sample. If a random sample is to be drawn, it must be clarified how it is to be drawn, how the randomisation principle is to be ensured, what response rate is expected, whether this is sufficient, how blank or obviously not seriously completed questionnaires are to be dealt with and where the limits for the use of the statements are drawn.

Announcement of the survey

In most hospitals, surveys may only be conducted with the consent or information of the staff representatives. The survey should always be publicised widely and in good time: Posters should be put up, announcements made at staff meetings, circulars sent to a wide audience. The questionnaire should be sent out with a cover letter from the management explaining the objectives, method and conditions of the survey.

Confidentiality

The confidentiality of the interview must be credibly assured to the employees. Personal interviews should be conducted by persons who do not belong to the organisation and who are bound to confidentiality. The client must respect confidentiality under all circumstances. Only information on criminal offences is excluded.

Return of the questionnaires

It is important to clarify how and when the questionnaires will be analysed. It is best to hand in a self-addressed envelope with the questionnaire to hold the completed form. The envelope can be placed in a collection box or sent by (in-house) post. It is recommended that the return envelope be sent to an address outside the company.

Results of the survey

The results of the survey should at least be discussed with representatives of the respondents and made known to them. The management should draw conclusions from the results for its actions, which should be communicated to the employees. This is the only way to prevent employees from perceiving surveys as a sham activity or irrelevant and refusing to participate.

Documentation

The data must be presented in such a way that the essentials are recognisable even for those who are not used to dealing with figures and bar charts, without suggesting certain conclusions. Distributor of the report?

Time required

Questionnaire preparation with printing: approx. 6 weeks Sending out the questionnaires until reporting: approx. 6 months

Responsibilities

Propose, prepare, print and send questionnaires	Authorised body
Coordination	QM Coordinator
Information, coordination	Employee representation
Collecting questionnaires, data entry, analysis	Authorised body
Acknowledgement, conclusions	Management

Notes and comments

Recently, great importance has been attached to employee surveys. It remains to be seen whether satisfaction can be reliably measured in this way.

Applicable documents

If applicable, Staff Representation Act, Works Constitution Act, works agreements

QM-RL G-BA:2015 §2 sentence 11 and §4 sentence 4, 10th emphasis

Attachments